三维适形后程逐步递量加速放疗颈段食管癌的近期观察  

Treatments of the Cervical Esophageal Carcinoma by Three-dimen-sional Conformal Radiotherapy With Accelerated Incremental Fractional Dose Escalation in the Boost Phase

作　　者：杨敬儒[1] 师颖瑞[1] 

机构地区：[1]湖南省肿瘤医院,湖南长沙410013

出　　处：《南华大学学报（医学版）》2010年第4期487-489,共3页Journal of Nanhua University(Medical Edition)

摘　　要：目的观察三维适形后程逐步递量加速放射治疗颈段食管癌的近期疗效和早期放射的治疗反应。方法对36例颈段食管癌放疗患者均采用8MV-X线照射,全程分两段行常规三维适形放疗。结果放疗结束后1个月和3个月CT及钡餐检查评价疗效,完全缓解(CR)6例,部分缓解(PR)19例,稳定(SD)6例,进展(PD)5例,总有效率为86%。急性放射性食管炎发生率I级58%(21/36),II级42%(15/36),III级42%(15/36),急性放射性肺炎发生率I、II级14%(5/36),III级6%(2/36)。结论三维适形后程逐步递量加速放射治疗颈段食管癌近期疗效满意,早期放射反应可以接受。Objective To study the early effects for cervical esophageal carcinoma treated by three dimensional conformal radiotherapy （3D - CRT） with accelerated incremental fractional dose escalation in the boost phase. Methods 36 cases of cervical esophageal carcinoma were treated with 3D - CRT. The 3D - CRT was divided into two phases. The initial phase was irradiated to 40Gy with 2Gy per fraction in 5 times one week, and the boost phase was designed as 3 incremental fractional dose schedule as 2.3Gy/fx. , 2.5Gy/fx. and 2.8Gy/fx. respectively, for which every dose schedule was consecutively irradiated for 3 times in 5 times 1 week, totally prescribed dose was 62.8Gy/6weeks. The target volume was shrinked accordingly as the second CT simulation scan indicated after the first phase irradiation. Results The evaluation was performed in 1 and 3 months post - radiation with CT scan and barium meal examination. 6 patients were in complete remission and 19 cases in partial remission, totally effective rate was 86%. The incidence of acute radiation esophagitis of grade 1 was 58% （21/36） , grade 2 and 3 was 42% （15/36） ; the acute radiation pneumonitis of grade 1 and 2 was 14% （5/36）, and grade 3 was 6% （2/36） respectively. Conclusion The treatment of cervical esophageal carcinoma with accelerated incremental fractional dose escalation in the boost phase is feasible with acceptable acute toxicities.

关 键 词：颈段食管癌 三维适形 放射疗法 

分 类 号：R735.1[医药卫生—肿瘤]